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In
psychology Psychology is the scientific study of mind and behavior. Its subject matter includes the behavior of humans and nonhumans, both consciousness, conscious and Unconscious mind, unconscious phenomena, and mental processes such as thoughts, feel ...
, stress is a
feeling According to the '' APA Dictionary of Psychology'', a feeling is "a self-contained phenomenal experience"; feelings are "subjective, evaluative, and independent of the sensations, thoughts, or images evoking them". The term ''feeling'' is closel ...
of emotional strain and pressure. Stress is a form of
psychological Psychology is the scientific study of mind and behavior. Its subject matter includes the behavior of humans and nonhumans, both consciousness, conscious and Unconscious mind, unconscious phenomena, and mental processes such as thoughts, feel ...
and mental discomfort. Small amounts of stress may be beneficial, as it can improve athletic performance,
motivation Motivation is an mental state, internal state that propels individuals to engage in goal-directed behavior. It is often understood as a force that explains why people or animals initiate, continue, or terminate a certain behavior at a particul ...
and reaction to the environment. Excessive amounts of stress, however, can increase the risk of
stroke Stroke is a medical condition in which poor cerebral circulation, blood flow to a part of the brain causes cell death. There are two main types of stroke: brain ischemia, ischemic, due to lack of blood flow, and intracranial hemorrhage, hemor ...
s,
heart attack A myocardial infarction (MI), commonly known as a heart attack, occurs when Ischemia, blood flow decreases or stops in one of the coronary arteries of the heart, causing infarction (tissue death) to the heart muscle. The most common symptom ...
s,
ulcer An ulcer is a discontinuity or break in a bodily membrane that impedes normal function of the affected organ. According to Robbins's pathology, "ulcer is the breach of the continuity of skin, epithelium or mucous membrane caused by sloughin ...
s, and
mental illness A mental disorder, also referred to as a mental illness, a mental health condition, or a psychiatric disability, is a behavioral or mental pattern that causes significant distress or impairment of personal functioning. A mental disorder is ...
es such as depression and also aggravate
pre-existing condition In the context of healthcare in the United States, a pre-existing condition is a medical condition that started before a person's health insurance went into effect. Before 2014, some insurance policies would not cover expenses due to pre-existin ...
s. Psychological stress can be external and related to the environment, but may also be caused by internal perceptions that cause an individual to experience
anxiety Anxiety is an emotion characterised by an unpleasant state of inner wikt:turmoil, turmoil and includes feelings of dread over Anticipation, anticipated events. Anxiety is different from fear in that fear is defined as the emotional response ...
or other negative emotions surrounding a situation, such as pressure,
discomfort Comfort is a state of physical or psychological ease, often characterized by the absence of hardship. Individuals experiencing a lack of comfort are typically described as uncomfortable or in discomfort. A degree of psychological comfort can b ...
, etc., which they then deem stressful.
Hans Selye János Hugo Bruno "Hans" Selye (; ; January 26, 1907 – October 16, 1982) was a Hungarian-Canadian endocrinologist who conducted important scientific work on the hypothetical non-specific response of an organism to stressors. Although he did ...
(1974) proposed four variations of stress. On one axis he locates good stress (
eustress The term eustress means "beneficial stress"—either psychological, physical (e.g., exercise), or biochemical/radiological (hormesis). The word was introduced by endocrinologist Hans Selye (1907–1982) in 1976; he combined the Greek prefix '' ...
) and bad stress (distress). On the other is over-stress (hyperstress) and understress (hypostress). Selye advocates balancing these: the ultimate goal would be to balance hyperstress and hypostress perfectly and have as much eustress as possible. The term "
eustress The term eustress means "beneficial stress"—either psychological, physical (e.g., exercise), or biochemical/radiological (hormesis). The word was introduced by endocrinologist Hans Selye (1907–1982) in 1976; he combined the Greek prefix '' ...
" comes from the Greek root ''eu-'' which means "good" (as in "euphoria"). Eustress results when a person perceives a stressor as positive. "Distress" stems from the Latin root ''dis-'' (as in "dissonance" or "disagreement"). Medically defined distress is a threat to the
quality of life Quality of life (QOL) is defined by the World Health Organization as "an individual's perception of their position in life in the context of the culture and value systems in which they live and in relation to their goals, expectations, standards ...
. It occurs when a demand vastly exceeds a person's capabilities.


Causes


Neutrality of stressors

Stress is a non-specific response. It is neutral, and what varies is the degree of response. It is all about the context of the individual and how they perceive the situation.
Hans Selye János Hugo Bruno "Hans" Selye (; ; January 26, 1907 – October 16, 1982) was a Hungarian-Canadian endocrinologist who conducted important scientific work on the hypothetical non-specific response of an organism to stressors. Although he did ...
defined stress as “the nonspecific (that is, common) result of any demand upon the body, be the effect mental or somatic.” This includes the medical definition of stress as a physical demand and the colloquial definition of stress as a psychological demand. A stressor is inherently neutral meaning that the same stressor can cause either distress or eustress. It is individual differences and responses that induce either distress or eustress.


Types of stressors

A
stressor A stressor is a chemical or biological agent, environmental condition, external stimulus or an event seen as causing stress to an organism. Psychologically speaking, a stressor can be events or environments that individuals might consider dema ...
is any event, experience, or environmental stimulus that causes stress in an individual. These events or experiences are perceived as threats or challenges to the individual and can be either physical or psychological. Researchers have found that stressors can make individuals more prone to both physical and psychological problems, including
heart disease Cardiovascular disease (CVD) is any disease involving the heart or blood vessels. CVDs constitute a class of diseases that includes: coronary artery diseases (e.g. angina pectoris, angina, myocardial infarction, heart attack), heart failure, ...
and
anxiety Anxiety is an emotion characterised by an unpleasant state of inner wikt:turmoil, turmoil and includes feelings of dread over Anticipation, anticipated events. Anxiety is different from fear in that fear is defined as the emotional response ...
.Pastorino, E. & Doyle-Portillo, S. (2009). What is Psychology?. 2nd Ed. Belmont, CA: Thompson Higher Education. Stressors are more likely to affect the health of an individual when they are "chronic, highly disruptive, or perceived as uncontrollable". In
psychology Psychology is the scientific study of mind and behavior. Its subject matter includes the behavior of humans and nonhumans, both consciousness, conscious and Unconscious mind, unconscious phenomena, and mental processes such as thoughts, feel ...
, researchers generally classify the different types of stressors into four categories: 1) crises/catastrophes, 2) major life events, 3) daily hassles/microstressors, and 4) ambient stressors. According to Ursin (1988), the common factor between these categories is an inconsistency between expected events ("set value") and perceived events ("actual value") that cannot be resolved satisfactorily, which puts stress into the broader context of cognitive-consistency theory.


Crises/catastrophes

This type of stressor is unforeseen and unpredictable and, as such, is completely out of the control of the individual. Examples of
crises A crisis (: crises; : critical) is any event or period that will lead to an unstable and dangerous situation affecting an individual, group, or all of society. Crises are negative changes in the human or environmental affairs, especially when ...
and catastrophes include: devastating
natural disaster A natural disaster is the very harmful impact on a society or community brought by natural phenomenon or Hazard#Natural hazard, hazard. Some examples of natural hazards include avalanches, droughts, earthquakes, floods, heat waves, landslides ...
s, such as major
flood A flood is an overflow of water (list of non-water floods, or rarely other fluids) that submerges land that is usually dry. In the sense of "flowing water", the word may also be applied to the inflow of the tide. Floods are of significant con ...
s or
earthquake An earthquakealso called a quake, tremor, or tembloris the shaking of the Earth's surface resulting from a sudden release of energy in the lithosphere that creates seismic waves. Earthquakes can range in intensity, from those so weak they ...
s,
war War is an armed conflict between the armed forces of states, or between governmental forces and armed groups that are organized under a certain command structure and have the capacity to sustain military operations, or between such organi ...
s,
pandemic A pandemic ( ) is an epidemic of an infectious disease that has a sudden increase in cases and spreads across a large region, for instance multiple continents or worldwide, affecting a substantial number of individuals. Widespread endemic (epi ...
s, etc. Though rare in occurrence, this type of stressor typically causes a great deal of stress in a person's life. A study conducted by Stanford University found that after natural disasters, those affected experienced a significant increase in stress level. Combat stress is a widespread acute and chronic problem. With the rapid pace and the urgency of firing first, accidental killings of friendly forces (or fratricide) may occur. Prevention requires stress reduction, emphasis on vehicle and other identification training, awareness of the tactical situation, and continual risk analysis by leaders at all levels.


Major life events

Common examples of major life events include:
marriage Marriage, also called matrimony or wedlock, is a culturally and often legally recognised union between people called spouses. It establishes rights and obligations between them, as well as between them and their children (if any), and b ...
, going to
college A college (Latin: ''collegium'') may be a tertiary educational institution (sometimes awarding degrees), part of a collegiate university, an institution offering vocational education, a further education institution, or a secondary sc ...
,
death Death is the end of life; the irreversible cessation of all biological functions that sustain a living organism. Death eventually and inevitably occurs in all organisms. The remains of a former organism normally begin to decompose sh ...
of a loved one,
birth Birth is the act or process of bearing or bringing forth offspring, also referred to in technical contexts as parturition. In mammals, the process is initiated by hormones which cause the muscular walls of the uterus to contract, expelling the f ...
of a child,
divorce Divorce (also known as dissolution of marriage) is the process of terminating a marriage or marital union. Divorce usually entails the canceling or reorganising of the legal duties and responsibilities of marriage, thus dissolving the M ...
, moving houses, etc. These events, either positive or negative, can create a sense of uncertainty and fear, which will ultimately lead to stress. For instance, research has found the elevation of stress during the transition from high school to university, with college freshmen being about two times more likely to be stressed than final year students. Research has found that major life events are somewhat less likely to be major causes of stress, due to their rare occurrences. The length of time since occurrence and whether or not it is a positive or negative event are factors in whether or not it causes stress and how much stress it causes. Researchers have found that events that have occurred within the past month generally are not linked to stress or illness, while chronic events that occurred more than several months ago are linked to stress and illness and personality change. Additionally, positive life events are typically not linked to stress and if so, generally only trivial stress while negative life events can be linked to stress and the health problems that accompany it. However, positive experiences and positive life changes can predict decreases in neuroticism.


Daily hassles/microstressors

This category includes daily
annoyance Annoyance is an unpleasant mental state that is characterized by irritation and distraction from one's conscious thinking. It can lead to emotions such as frustration and anger. The property of being easily annoyed is called irritability. P ...
s and minor hassles. Examples include: making decisions, meeting deadlines at work or school, traffic jams, encounters with irritating personalities, etc. Often, this type of stressor includes conflicts with other people. Daily stressors, however, are different for each individual, as not everyone perceives a certain event as stressful. For example, most people find public speaking to be stressful, but someone who has experience with it will not. Daily hassles are the most frequently occurring type of stressor in most adults. The high frequency of hassles causes this stressor to have the most physiological effect on an individual. Carolyn Aldwin, Ph.D., conducted a longitudinal study on older men (mean age ca. 66 years at the time of first stress assessment) at the Oregon State University that examined the perceived intensity of daily hassles on an individual's mortality. Aldwin's study concluded that there is a strong correlation between individuals who rate their hassles as very intense and a high level of mortality. One's perception of their daily stressors can have a modulating effect on the physiological impact of daily stressors. There are three major psychological types of conflicts that can cause stress. * The approach-approach conflict, occurs when a person is choosing between two equally attractive options, i.e. whether to go see a movie or to go see a concert. * The avoidance-avoidance conflict, occurs where a person has to choose between two equally unattractive options, for example, to take out a second loan with unappealing terms to pay off the mortgage or to face foreclosure on one's house. * The approach-avoidance conflict, occurs when a person is forced to choose whether or not to partake in something that has both attractive and unattractive traits such as whether or not to attend an expensive college (meaning taking out loans now, but also meaning a quality education and employment after graduation). Travel-related stress results from three main categories: lost time, surprises (an unforeseen event such as lost or delayed baggage) and routine breakers (inability to maintain daily habits).


Ambient stressors

As the name implies, these are global (as opposed to individual) low-grade stressors that are a part of the background environment. They are defined as stressors that are "chronic, negatively valued, non-urgent, physically perceptible, and intractable to the efforts of individuals to change them". Typical examples of ambient stressors are pollution, noise, crowding, and traffic. Unlike the other three types of stressor, ambient stressors can (but do not necessarily have to) negatively impact stress without conscious awareness.


Organisational stressors

Studies conducted in military and combat fields show that some of the most potent stressors can be due to personal organisational problems in the unit or on the home front. Stress due to bad organisational practices is often connected to "toxic leadership", both in companies and in governmental organisations.


Stressor impact

Life events scales can be used to assess stressful things that people experience in their lives. One such scale is the
Holmes and Rahe Stress Scale The Holmes and Rahe stress scale (), also known as the Social Readjustment Rating Scale, is a list of 43 stressful life events that can contribute to illness. The test works via a point accumulation score which then gives an assessment of risk. ...
, also known as the Social Readjustment Rating Scale, or SRRS. Developed by psychiatrists Thomas Holmes and Richard Rahe in 1967, the scale lists 43 stressful events. To calculate one's score, add up the number of "life change units" if an event occurred in the past year. A score of more than 300 means that individual is at risk for illness, a score between 150 and 299 means risk of illness is moderate, and a score under 150 means that individual only has a slight risk of illness. A modified version was made for non-adults. The scale is below. The SRRS is used in psychiatry to weight the impact of life events.


Measurement

Modern people may attempt to self-assess their own "stress-level"; third parties (sometimes clinicians) may also provide qualitative evaluations. Quantitative approaches such as
Galvanic Skin Response Electrodermal activity (EDA) is the property of the human body that causes continuous variation in the electrical characteristics of the skin. Historically, EDA has also been known as skin conductance, galvanic skin response (GSR), electroderm ...
or other measurements giving results which may correlate with perceived psychological stress include testing for one or more of the several
stress hormone Stress hormones are secreted by endocrine glands to modify one's internal environment during times of stress. By performing various functions such as mobilizing energy sources, increasing heart rate, and downregulating metabolic processes which ...
s, for cardiovascular responses, or for immune response. There are some valid questionnaires to assess stress level such as, Higher Education Stress Inventory (HESI) is a valid questionnaire used in many communities for assessment the stress level of college students. There are many (psycho-)physiological measurement methods that correlate more or less well with psychological stress (mental or emotional) and are thus used as a possible indicator. In the physiological domain of oculomotor function alone, several physiological responses are suspected to detect different stress situations in a person-specific and objective manner (not by means of a survey). For example, via eye movement and gaze behavior, via pupil behavior and via eyelid blink behavior (
Blinking Blinking is a bodily function; it is a semi-autonomic rapid closing of the eyelid. A single blink is determined by the forceful closing of the eyelid or inactivation of the levator palpebrae superioris and the activation of the palpebral por ...
).


Physical effects

To measure the body's response to stress, psychologists tend to use Hans Selye's
general adaptation syndrome Stress, whether physiological, biological or psychological, is an organism's response to a stressor, such as an environmental condition or change in life circumstances. When stressed by stimuli that alter an organism's environment, multipl ...
. This biological model, often referred to as the "classic stress response", revolves around the concept of
homeostasis In biology, homeostasis (British English, British also homoeostasis; ) is the state of steady internal physics, physical and chemistry, chemical conditions maintained by organism, living systems. This is the condition of optimal functioning fo ...
. General adaptive syndrome, according to this system, occurs in three stages: #The alarm reaction. This stage occurs when the stressor is first presented. The body begins to gather resources to deal with the stressor. The hypothalamic-pituitary-adrenal axis and
sympathetic nervous system The sympathetic nervous system (SNS or SANS, sympathetic autonomic nervous system, to differentiate it from the somatic nervous system) is one of the three divisions of the autonomic nervous system, the others being the parasympathetic nervous sy ...
are activated, resulting in the release of hormones from the
adrenal gland The adrenal glands (also known as suprarenal glands) are endocrine glands that produce a variety of hormones including adrenaline and the steroids aldosterone and cortisol. They are found above the kidneys. Each gland has an outer adrenal corte ...
such as
cortisol Cortisol is a steroid hormone in the glucocorticoid class of hormones and a stress hormone. When used as medication, it is known as hydrocortisone. Cortisol is produced in many animals, mainly by the ''zona fasciculata'' of the adrenal corte ...
, adrenaline (
epinephrine Adrenaline, also known as epinephrine, is a hormone and medication which is involved in regulating visceral functions (e.g., respiration). It appears as a white microcrystalline granule. Adrenaline is normally produced by the adrenal glands a ...
), and
norepinephrine Norepinephrine (NE), also called noradrenaline (NA) or noradrenalin, is an organic compound, organic chemical in the catecholamine family that functions in the brain and human body, body as a hormone, neurotransmitter and neuromodulator. The ...
into the bloodstream to adjust bodily processes. These hormonal adjustments increase energy-levels, increase muscle tension, reduce sensitivity to pain, slow down the digestive system, and cause a rise in blood pressure.Gottlieb, Benjamin."Coping with Chronic Stress". Plenum Press. 1997. In addition, the
locus coeruleus The locus coeruleus () (LC), also spelled locus caeruleus or locus ceruleus, is a nucleus in the pons of the brainstem involved with physiological responses to stress and panic. It is a part of the reticular activating system in the reticular ...
, a collection of norepinephrine-containing neurons in the
pons The pons (from Latin , "bridge") is part of the brainstem that in humans and other mammals, lies inferior to the midbrain, superior to the medulla oblongata and anterior to the cerebellum. The pons is also called the pons Varolii ("bridge of ...
of the
brainstem The brainstem (or brain stem) is the posterior stalk-like part of the brain that connects the cerebrum with the spinal cord. In the human brain the brainstem is composed of the midbrain, the pons, and the medulla oblongata. The midbrain is conti ...
whose axons project to various regions of the brain, is involved in releasing norepinephrine directly onto neurons. High levels of norepinephrine acting as a neurotransmitter on its receptors expressed on neurons in brain regions, such as the
prefrontal cortex In mammalian brain anatomy, the prefrontal cortex (PFC) covers the front part of the frontal lobe of the cerebral cortex. It is the association cortex in the frontal lobe. The PFC contains the Brodmann areas BA8, BA9, BA10, BA11, BA12, ...
, are thought to be involved in the effects of stress on
executive functions In cognitive science and neuropsychology, executive functions (collectively referred to as executive function and cognitive control) are a set of cognitive processes that support goal-directed behavior, by regulating thoughts and actions thro ...
, such as impaired
working memory Working memory is a cognitive system with a limited capacity that can Memory, hold information temporarily. It is important for reasoning and the guidance of decision-making and behavior. Working memory is often used synonymously with short-term m ...
. #The stage of resistance. The body continues building up resistance throughout the stage of resistance, either until the body's resources are depleted, leading to the exhaustion phase, or until the stressful stimulus is removed. As the body uses up more and more of its resources, it becomes increasingly tired and susceptible to illness. At this stage
psychosomatic Somatic symptom disorder, also known as somatoform disorder or somatization disorder, is chronic somatization. One or more chronic physical symptoms coincide with excessive and maladaptive thoughts, emotions, and behaviors connected to those symp ...
disorders first begin to appear. #The stage of exhaustion. The body is completely drained of the hormones and resources it was depending on to manage the stressor. The person now begins to exhibit behaviors such as anxiety, irritability, avoidance of responsibilities and relationships, self-destructive behavior, and poor judgment. Someone experiencing these symptoms has a much greater chance of lashing out, damaging relationships, or avoiding social interaction at all. This
physiological stress Stress, whether physiological, biological or psychological, is an organism's response to a stressor, such as an environmental condition or change in life circumstances. When stressed by stimuli that alter an organism's environment, multiple s ...
response involves high levels of
sympathetic nervous system The sympathetic nervous system (SNS or SANS, sympathetic autonomic nervous system, to differentiate it from the somatic nervous system) is one of the three divisions of the autonomic nervous system, the others being the parasympathetic nervous sy ...
activation, often referred to as the "fight or flight" response. Th
response
involves pupil dilation, release of
endorphins Endorphins (contracted from endogenous morphine) are peptides produced in the brain that block the perception of pain and increase feelings of wellbeing. They are produced and stored in the pituitary gland of the brain. Endorphins are endogeno ...
, increased heart and respiration rates, cessation of digestive processes, secretion of adrenaline, arteriole dilation, and constriction of veins.


Cancer

Psychological stress does not appear to be a risk factor for the onset of cancer, though it may worsen outcomes in those who already have cancer. Research has found that personal belief in stress as a risk factor for cancer was common in
England England is a Countries of the United Kingdom, country that is part of the United Kingdom. It is located on the island of Great Britain, of which it covers about 62%, and List of islands of England, more than 100 smaller adjacent islands. It ...
, though awareness of risk factors overall was found to be low.


Other effects

There is likely a connection between stress and illness. Theories of a proposed stress–illness link suggest that both acute and chronic stress can cause illness, and studies have found such a link. According to these theories, both kinds of stress can lead to changes in behavior and in physiology. Behavioral changes can involve smoking and eating habits and physical activity. Physiological changes can be changes in sympathetic activation or hypothalamic pituitary adrenocorticoid activation, and immunological function. However, there is much variability in the link between stress and illness.Ogden, J. (2007). Health Psychology: a textbook (4th ed.), pages 281–282 New York: McGraw-Hill There is some evidence that stress can make the individual more susceptible to physical illnesses like the common cold. "Although chronic (but not acute) stressful events are associated with greater susceptibility, the association between social diversity and colds is not altered after controlling for life events." Stressful events, such as job changes, correlate with insomnia, impaired sleeping, and health complaints. Research indicates the type of stressor (whether it is acute or chronic) and individual characteristics such as age and physical well-being before the onset of the stressor can combine to determine the effect of stress on an individual. An individual's personality characteristics (such as level of
neuroticism Neuroticism is a personality trait associated with negative emotions. It is one of the Big Five traits. Individuals with high scores on neuroticism are more likely than average to experience such feelings as anxiety, worry, fear, anger, shame ...
), genetics, and childhood experiences with major stressors and traumas may also dictate their response to stressors. Stress may also cause
headaches A headache, also known as cephalalgia, is the symptom of pain in the face, head, or neck. It can occur as a migraine, tension-type headache, or cluster headache. There is an increased risk of depression in those with severe headaches. Head ...
.
Chronic stress Chronic stress is the physiological or psychological response induced by a long-term internal or external stressor. The stressor, either physically present or recollected, will produce the same effect and trigger a chronic stress response. There ...
and a lack of coping resources available or used by an individual can often lead to the development of psychological issues such as depression and
anxiety Anxiety is an emotion characterised by an unpleasant state of inner wikt:turmoil, turmoil and includes feelings of dread over Anticipation, anticipated events. Anxiety is different from fear in that fear is defined as the emotional response ...
. This is particularly true regarding chronic stressors. These are stressors that may not be as intense as an acute stressor like a natural disaster or a major accident, but they persist over longer periods of time. These types of stressors tend to have a more negative impact on health because they are sustained and thus require the body's physiological response to occur daily. This depletes the body's
energy Energy () is the physical quantity, quantitative physical property, property that is transferred to a physical body, body or to a physical system, recognizable in the performance of Work (thermodynamics), work and in the form of heat and l ...
more quickly and usually occurs over long periods of time, especially when such microstressors cannot be avoided (for example: stress related to living in a dangerous neighborhood). Chronic stress may lead to
allostatic load Allostatic load is "the wear and tear on the body" which accumulates as an individual is exposed to repeated or chronic Stress (biology), stress. The term was coined by Bruce McEwen and Eliot Stellar in 1993. It represents the physiological conseq ...
, a biological process affecting many physiological systems. For example, studies have found that caregivers, particularly those of dementia patients, have higher levels of depression and slightly worse physical health than non-caregivers. Studies have also shown that perceived chronic stress and the hostility associated with Type A personalities are often correlated with much higher risks of cardiovascular disease. This occurs because of the compromised immune system as well as the high levels of arousal in the sympathetic nervous system that occur as part of the body's physiological response to stressful events. However, it is possible for individuals to exhibit hardiness a term referring to the ability to be both chronically stressed and healthy. Chronic stress can correlate with psychological disorders such as
delusions A delusion is a fixed belief that is not amenable to change in light of conflicting evidence. As a pathology, it is distinct from a belief based on false or incomplete information, confabulation, dogma, illusion, hallucination, or some other m ...
. Pathological anxiety and chronic stress lead to structural degeneration and impaired functioning of the
hippocampus The hippocampus (: hippocampi; via Latin from Ancient Greek, Greek , 'seahorse'), also hippocampus proper, is a major component of the brain of humans and many other vertebrates. In the human brain the hippocampus, the dentate gyrus, and the ...
. It has long been believed that negative affective states, such as feelings of anxiety and depression, could influence the pathogenesis of physical disease, which in turn, have direct effects on biological process that could result in increased risk of disease in the end. However, studies done by the University of Wisconsin-Madison and other places have shown this to be partly untrue; although perceived stress seems to increase the risk of reported poor health, the additional ''perception'' of stress as something harmful increases the risk even further. For example, when humans are under chronic stress, permanent changes in their physiological, emotional, and behavioral responses are most likely to occur. Such changes could lead to disease. Chronic stress results from stressful events that persist over a relatively long period of time, such as caring for a spouse with dementia, or results from brief focal events that continue to be experienced as overwhelming even long after they are over, such as experiencing a sexual assault. Experiments show that when healthy human individuals are exposed to acute laboratory stressors, they show an adaptive enhancement of some markers of natural immunity but a general suppression of functions of specific immunity. By comparison, when healthy human individuals are exposed to real-life chronic stress, this stress is associated with a biphasic immune response where partial suppression of cellular and humoral function coincides with low-grade, nonspecific inflammation. Even though psychological stress is often connected with illness or disease, most healthy individuals can still remain disease-free after confronting chronic stressful events. Also, people who do not believe that stress will affect their health do not have an increased risk of illness, disease, or death. This suggests that there are individual differences in vulnerability to the potential pathogenic effects of stress; individual differences in vulnerability arise due to both genetic and psychological factors. In addition, the age at which the stress is experienced can dictate its effect on health. Research suggests chronic stress at a young age can have lifelong impacts on the biological, psychological, and behavioral responses to stress later in life.


Social impact


Communication

When someone is stressed, many challenges can arise; a recognised challenge being communication difficulties. Here are some examples of how stress can hinder communication. The cultures of the world generally fall into two categories; individualistic and collectivistic. * An
individualistic Individualism is the moral stance, political philosophy, ideology, and social outlook that emphasizes the intrinsic worth of the individual. Individualists promote realizing one's goals and desires, valuing independence and self-reliance, and a ...
culture, like that of the United States, where everyone is an independent entity defined by their accomplishments and goals. * A
collectivistic In sociology, a social organization is a pattern of relationships between and among individuals and groups. Characteristics of social organization can include qualities such as sexual composition, spatiotemporal cohesion, leadership, structu ...
culture, like that of many Asian countries, prefers to see individuals as interdependent on each other. They value modesty and family. These cultural differences can affect how people communicate when they are stressed. For example, a member of an individualistic culture would be hesitant to ask for pain medication for fear of being perceived as weak. A member of a collectivistic culture would not hesitate. They have been brought up in a culture where everyone helps each other and is one functional unit whereas the member of the individualistic culture is not as comfortable asking others for aid.


Language barriers

Language barriers can cause stress, and sometimes this stress adds to language barriers. People may feel uncomfortable with the difficulties caused by differences in syntax, vocabulary, ways of showing respect, and use of body language. Along with a desire for successful social interactions, being uncomfortable with the communication around a person can discourage them from communicating at all, thus adding to the language barrier. The System 1 – System 2 model of
Daniel Kahneman Daniel Kahneman (; ; March 5, 1934 – March 27, 2024) was an Israeli-American psychologist best known for his work on the psychology of judgment and decision-making as well as behavioral economics, for which he was awarded the 2002 Nobel Memor ...
's
Thinking, Fast and Slow ''Thinking, Fast and Slow'' is a 2011 popular science book by psychologist Daniel Kahneman. The book's main thesis is a differentiation between two modes of thought: "System 1" is fast, instinctive and emotional; "System 2" is slower, more delib ...
and others distinguishes between automatic responses, such as those one's native language provides, and a foreign language that requires System 2 work to translate. System 2 can become "depleted" by conscious mental effort, making it more difficult and stressful.


Changes in the home

Divorce, death, and remarriage are all disruptive events in a household. Although everyone involved is affected by events such as these, it can be most drastically seen in children. Due to their age, children have relatively undeveloped coping skills. For this reason a stressful event may cause some changes in their behavior. Falling in with a new crowd, developing some new and sometimes undesirable habits are just some of the changes stress may trigger in their lives. A particularly interesting response to stress is talking to an
imaginary friend Imaginary friends (also known as pretend friends, invisible friends or made-up friends) are a psychological and a social phenomenon where a friendship or other interpersonal relationship takes place in the imagination rather than physical reali ...
. A child may feel angry with a parent or their peers who they feel brought this change on them. They need someone to talk to but it definitely would not be the person with whom they are angry. That is when the imaginary friend comes in. They “talk” to this imaginary friend but in doing so they cut off communication with the real people around them.


Social support and health

Researchers have long been interested in how an individual's level and types of
social support Social support is the perception and actuality that one is cared for, has assistance available from other people, and, most popularly, that one is part of a supportive social network. These supportive resources can be emotional (e.g., nurturance), ...
impact the effect of stress on their health. Studies consistently show that social support can protect against physical and mental consequences of stress. This can occur through a variety of mechanisms. One model, known as the "direct effects" model, holds that social support has a direct, positive impact on health by increasing positive affect, promoting adaptive health behaviors, predictability and stability in life, and safeguarding against social, legal, and economic concerns that could negatively impact health. Another model, the "buffering effect", says that social support exerts greatest influence on health in times of stress, either by helping individuals appraise situations in less threatening manners or coping with the actual stress. Researchers have found evidence to support both these pathways. Social support is defined more specifically as psychological and material resources provided by a social network that are aimed at helping an individual cope with stress. Researchers generally distinguish among several types of social support: instrumental support – which refers to material aid (e.g., financial support or assistance in transportation to a physician's appointment), informational support (e.g., knowledge, education or advice in problem-solving), and emotional support (e.g., empathy, reassurance, etc.). Social support can reduce the rate of stress during pregnancy. Studies have found that those who had a large change in their life with a small amount of social support has a higher chance of complications. Whereas those with a larger support system would have a chance for less complications.


Management

Stress management Stress management consists of a wide spectrum of techniques and psychotherapy, psychotherapies aimed at controlling a person's level of psychological stress, especially chronic stress, generally for the purpose of improving the function of everyda ...
refers to a wide spectrum of techniques and psychotherapies aimed at controlling a person's levels of stress, especially chronic stress, usually for the purpose of improving everyday functioning. It involves controlling and reducing the tension that occurs in stressful situations by making emotional and physical changes.


Prevention and resilience building

Decreasing stressful behaviors is a part of prevention. Some of the common strategies and techniques are: self-monitoring, tailoring, material reinforcement, social reinforcement, social support, self-contracting, contracting with significant other, shaping, reminders, self-help groups, and professional help. Although many techniques have traditionally been developed to deal with the consequences of stress, considerable research has also been conducted on the prevention of stress, a subject closely related to psychological resilience-building. A number of self-help approaches to stress-prevention and resilience-building have been developed, drawing mainly on the theory and practice of cognitive-behavioral therapy.
Biofeedback Biofeedback is the technique of gaining greater awareness of many physiology, physiological functions of one's own body by using Electronics, electronic or other instruments, and with a goal of being able to Manipulation (psychology), manipulate ...
may also play a role in stress management. A randomized study by Sutarto et al. assessed the effect of resonant breathing biofeedback (recognize and control involuntary heart rate variability) among manufacturing operators; depression, anxiety and stress significantly decreased.


Exercising to reduce stress

Studies have shown that exercise reduces stress. Exercise effectively reduces fatigue, improves sleep, enhances overall cognitive function such as alertness and concentration, decreases overall levels of tension, and improves self-esteem. Because many of these are depleted when an individual experiences chronic stress, exercise provides an ideal coping mechanism. Despite popular belief, it is not necessary for exercise to be routine or intense in order to reduce stress; as little as five minutes of aerobic exercise can begin to stimulate anti-anxiety effects. Further, a 10-minute walk may have the same psychological benefits as a 45-minute workout, reinforcing the assertion that exercise in any amount or intensity will reduce stress. Cycling and walking activities have lower stress scores when compared to other modes of transport or commuting.


Theoretical explanations

A multitude of theories have been presented in attempts to explain why exercise effectively reduces stress. One theory, known as the time-out hypothesis, claims that exercise provides distraction from the stressor. The time out hypothesis claims that exercise effectively reduces stress because it gives individuals a break from their stressors. This was tested in a recent study of college women who had identified studying as their primary stressor. The women were then placed under four conditions at varying times: "rest," "studying," "exercising," and "studying while exercising." The stress levels of the participants were measured through self-assessments of stress and anxiety symptoms after each condition. The results demonstrated that the "exercise" condition had the most significant reduction in stress and anxiety symptoms. These results demonstrate the validity of the time-out hypothesis. It is also important to note that exercise provided greater stress reduction than rest.


Coping mechanisms

The Lazarus and Folkman model suggests that external events create a form of pressure to achieve, engage in, or experience a stressful situation. Stress is not the external event itself, but rather an interpretation and response to the potential threat; this is when the coping process begins. There are various ways individuals deal with perceived threats that may be stressful. However, people have a tendency to respond to threats with a predominant coping style, in which they dismiss feelings, or manipulate the stressful situation. There are different classifications for coping, or
defense mechanisms In psychoanalytic theory, defence mechanisms are unconscious psychological processes that protect the self from anxiety-producing thoughts and feelings related to internal conflicts and external stressors. According to this theory, healthy ...
, however they all are variations on the same general idea: There are good/productive and negative/counterproductive ways to handle stress. Because stress is perceived, the following mechanisms do not necessarily deal with the actual situation that is causing an individual stress. However, they may be considered coping mechanisms if they allow the individual to cope better with the negative feelings/anxiety that they are experiencing due to the perceived stressful situation, as opposed to actually fixing the concrete obstacle causing the stress. The following mechanisms are adapted from the DSM-IV Adaptive Functioning Scale, APA, 1994. Another way individuals can cope with stress is by the way one perceives stress. Perceptions of stress are critical for making decisions and living everyday life. The outlook or the way an individual perceives the given situation can affect the manner to which the individual handles stress, whether it be positive or negative. Too much stress can be detrimental to the individual and can cause negative psychological and physical health effects.


Highly adaptive/active/problem-focused mechanisms

These skills are what one could call as “facing the problem head on”, or at least dealing with the negative emotions experienced by stress in a constructive manner. (generally adaptive) * Affiliation ("
tend and befriend Tend-and-befriend is a purported behavior exhibited by some animals, including humans, in response to threat. It refers to protection of offspring (tending) and seeking out their social group for mutual defense (befriending). In evolutionary psyc ...
") – involves dealing with stress by turning to a social network for support, but an individual does not share with others in order to diffuse or avoid the responsibility.Adapted from DSM-IV Adaptive Functioning Scale, APA, 1994. *
Humour Humour (English in the Commonwealth of Nations, Commonwealth English) or humor (American English) is the tendency of experiences to provoke laughter and provide amusement. The term derives from the humorism, humoral medicine of the ancient Gre ...
– the individual steps outside of a situation in order to gain greater perspective, and also to highlight any comic aspect to be found in their stressful circumstances. ::“The Association for Applied and Therapeutic Humour defines therapeutic humour as ‘any intervention that promotes health and wellness by stimulating a playful discovery, expression or appreciation of the absurdity of or incongruity of life’s situations. This intervention may enhance health or be used as a complementary treatment of illness to facilitate healing or coping whether physical, emotional, cognitive, or spiritual”. ::
Sigmund Freud Sigmund Freud ( ; ; born Sigismund Schlomo Freud; 6 May 1856 – 23 September 1939) was an Austrian neurologist and the founder of psychoanalysis, a clinical method for evaluating and treating psychopathology, pathologies seen as originating fro ...
, suggested that humour was an excellent defensive strategy in emotional situations. When one laughs during a tough situation they feel absent from their worries, and this allows them to think differently. When one experiences a different mind set, they feel more in control of their response, and how they would go about dealing with the event that caused stress. ::Lefcourt (2001) suggests that this perspective-taking humour is the most effective due to its ability to distance oneself from the situation of great stress. Studies show that the use of laughter and humour creates a sense of relief of stress that can last up to 45 minutes post-laughter. ::Also, most hospitalized children have been seen to use laughter and play to relieve their fear, pain and stress. It has been discovered that there is a great importance in the use of laughter and humour in stress coping. Humans should use humour as a means to transcend their original understanding of an external event, take a different perspective, in which their anxiety may be minimized by. * Sublimation – allows an "indirect resolution of conflict with neither adverse consequences nor consequences marked by loss of pleasure." Essentially, this mechanism allows channeling of troubling emotions or impulses into an outlet that is socially acceptable. * Positive reappraisal – redirects thoughts (cognitive energy) to good things that are either occurring or have not occurred. This can lead to
personal growth Personal development or self-improvement consists of activities that develops a person's capabilities and potential, enhance quality of life, and facilitate the realization of dreams and aspirations. Personal development may take place over the c ...
,
self-reflection Self-reflection is the ability to witness and evaluate one's own cognitive, emotional, and behavioural processes. In psychology, other terms used for this self-observation include "reflective awareness" and "reflective consciousness", which or ...
, and awareness of the power/benefits of one's efforts. For example, studies on
veteran A veteran () is a person who has significant experience (and is usually adept and esteemed) and expertise in an job, occupation or Craft, field. A military veteran is a person who is no longer serving in the military, armed forces. A topic o ...
s of war or peacekeeping operations indicate that persons who construe a positive meaning from their combat or threat experiences tend to adjust better than those who do not. Other adaptive coping mechanisms include
anticipation Anticipation is an emotion involving pleasure or anxiety in considering or awaiting an expected event. Anticipatory emotions include fear, anxiety, hope, and trust. When the anticipated event fails to occur, it results in disappointment (for ...
,
altruism Altruism is the concern for the well-being of others, independently of personal benefit or reciprocity. The word ''altruism'' was popularised (and possibly coined) by the French philosopher Auguste Comte in French, as , for an antonym of egoi ...
, and
self-observation In philosophy, self-awareness is the awareness and reflection of one's own personality or individuality, including traits, feelings, and behaviors. It is not to be confused with consciousness in the sense of qualia. While consciousness is be ...
.


Mental inhibition/disavowal mechanisms

These mechanisms cause the individual to have a diminished (or in some cases non-existent) awareness about their anxiety, threatening ideas, fears, etc., that come from being conscious of the perceived threat. *
Displacement Displacement may refer to: Physical sciences Mathematics and physics *Displacement (geometry), is the difference between the final and initial position of a point trajectory (for instance, the center of mass of a moving object). The actual path ...
– This is when an individual redirects their emotional feelings about one situation to another, less threatening one. * Repression – Repression occurs when an individual attempts to remove all their thoughts, feelings, and anything related to the upsetting/stressful (perceived) threat out of their awareness in order to be disconnected from the entire situation. When done long enough in a successful way, this is more than just denial. *
Reaction formation In psychoanalytic theory, reaction formation () is a defense mechanism in which emotions, desires and impulses that are anxiety-producing or unacceptable to the Ego (Freudian), ego are mastered by exaggeration of the directly opposing tendency.Char ...
– An attempt to remove any “unacceptable thoughts” from one's consciousness by replacing them with the exact opposite. Other inhibition coping mechanisms include undoing, dissociation,
denial Denial, in colloquial English usage, has at least three meanings: * the assertion that any particular statement or allegation, whose truth is uncertain, is not true; * the refusal of a request; and * the assertion that a true statement is fal ...
,
projection Projection or projections may refer to: Physics * Projection (physics), the action/process of light, heat, or sound reflecting from a surface to another in a different direction * The display of images by a projector Optics, graphics, and carto ...
, and
rationalization Rationalization may refer to: * Rationalization (economics), an attempt to change an ''ad hoc'' workflow into one based on published rules; also, jargon for a reduction in staff * Rationalisation (mathematics), the process of removing a square roo ...
. Although some people claim that inhibition coping mechanisms may eventually increase the stress level because the problem is not solved, detaching from the stressor can sometimes help people to temporarily release the stress and become more prepared to deal with problems later on.


Active mechanisms

These methods deal with stress by an individual literally taking action, or withdrawing. *
Acting out In the psychology of defense mechanisms and self-control, acting out is the performance of an action considered bad or anti-social. They indirectly express emotions through behavior rather than words. These actions are often used to cope with un ...
– Often viewed as counter-normative, or problematic behavior. Instead of reflecting or problem-solving, an individual takes maladaptive action. *
Passive aggression Passive-aggressive behavior is characterized by a pattern of passive hostility and an avoidance of direct communication. Inaction where some action is socially customary is a typical passive-aggressive strategy (showing up late for functions, s ...
– When an individual indirectly deals with their anxiety and negative thoughts/feelings stemming from their stress by acting in a hostile or resentful manner towards others. Help-Rejecting Complaining can also be included in this category.


Health promotion

There is an alternative method to coping with stress, in which one works to minimize their anxiety and stress in a preventative manner. Suggested strategies to improve stress management include: # Regular exercise – set up a fitness program, 3–4 times a week # Support systems – to listen, offer advice, and support each other # Time management – develop an organizational system # Guided imagery and visualization – create a relaxing state of mind # Progressive muscle relaxation – loosen tense muscle groups #
Assertiveness Assertiveness is the quality of being self-assured and confident without being aggressive to defend a right point of view or a relevant statement. In the field of psychology and psychotherapy, it is a skill that can be learned and a mode of communi ...
training – work on effective communication # Journal writing – express true emotion, self-reflection # Stress management in the workplace – organize a new system, switch tasks to reduce own stress. Depending on the situation, all of these coping mechanisms may be adaptive, or maladaptive.


History

Prior to the introduction of the concept "stress" in the psychological sense 1955, people already identified a range of more nuanced ideas to describe and confront such
emotion Emotions are physical and mental states brought on by neurophysiology, neurophysiological changes, variously associated with thoughts, feelings, behavior, behavioral responses, and a degree of pleasure or suffering, displeasure. There is ...
s as
worry Worrying is the mental distress or agitation resulting from anxiety, usually coming from a place of anticipatory fear (terror) or fear coming from a present threat (horror). With more understanding of the situation, worry becomes concern, the ...
,
grief Grief is the response to the loss of something deemed important, particularly to the death of a person to whom or animal to which a Human bonding, bond or affection was formed. Although conventionally focused on the emotional response to loss, ...
, concern,
obsession Obsession may refer to: Psychology * Celebrity worship syndrome, obsessive addictive disorder to a celebrity's personal and professional life * Obsession (psychology), a persistent attachment to an object or idea * Fixation (psychology), persist ...
,
fear Fear is an unpleasant emotion that arises in response to perception, perceived dangers or threats. Fear causes physiological and psychological changes. It may produce behavioral reactions such as mounting an aggressive response or fleeing the ...
,
annoyance Annoyance is an unpleasant mental state that is characterized by irritation and distraction from one's conscious thinking. It can lead to emotions such as frustration and anger. The property of being easily annoyed is called irritability. P ...
,
anxiety Anxiety is an emotion characterised by an unpleasant state of inner wikt:turmoil, turmoil and includes feelings of dread over Anticipation, anticipated events. Anxiety is different from fear in that fear is defined as the emotional response ...
, distress,
suffering Suffering, or pain in a broad sense, may be an experience of unpleasantness or aversion, possibly associated with the perception of harm or threat of harm in an individual. Suffering is the basic element that makes up the negative valence (psyc ...
and
passion Passion, the Passion or the Passions may refer to: Emotion * Passion (emotion), a very strong feeling about a person or thing * Passions (philosophy), emotional states as used in philosophical discussions * Stoic passions, various forms of emotio ...
. By the 19th century, the popularisation of the nascent science of
neurology Neurology (from , "string, nerve" and the suffix wikt:-logia, -logia, "study of") is the branch of specialty (medicine) , medicine dealing with the diagnosis and treatment of all categories of conditions and disease involving the nervous syst ...
made it possible to group some undifferentiated combination of one or more of these with an informal diagnosis such as "
nerve A nerve is an enclosed, cable-like bundle of nerve fibers (called axons). Nerves have historically been considered the basic units of the peripheral nervous system. A nerve provides a common pathway for the Electrochemistry, electrochemical nerv ...
strain". "Stress" has subsequently become a mainstay of
pop psychology Popular psychology (sometimes shortened as pop psychology or pop psych) refers to the concepts and theories about human mental life and behavior that are supposedly based on psychology and are considered credible and accepted by the wider populac ...
. Though stress is discussed throughout history from many distinct topics and cultures, there is no universal consensus over describing stress. This has led to multiple kinds of research, looking at the different aspects of psychological stress and how it changes over a lifespan.


See also


References


Further reading

* *


External links

* {{Authority control Psychological stress